Ice and Heat Treatments

For many patients who sustain minor injuries such as sprains and strains, ice and heat can provide therapeutic benefit.  The question is often raised, “which modality do I use – and when?”  Generally speaking, ice is recommended for use immediately following an injury or intense workout and up to 48 hours thereafter, while heat is beneficial in the subacute setting or for chronic injuries.

Ice or cold temperatures causes vasoconstriction (narrowing of the blood vessels) that are normally dilated and leaky after an injury.  Constricting the circulation modulates blood flow to the site of injury thereby limiting local swelling, bleeding, and pro-inflammatory proteins that are responsible for many of the aches and pains experienced after an injury.  Additionally, ice or cold therapy (cryotherapy) can slow down tissue metabolism and the unintended tissue breakdown after an injury or intense workout.  When the cold source is removed, the skin and underlying tissue return to normal temperature and restore faster blood flow which acts to “flush” the local system of unwanted byproducts of tissue breakdown and injury.  When ice is issued, care should be taken to avoid thermal injury such as frostbite. Children should be supervised by an adult and monitored appropriately.  Generally, no more than 20 continuous minutes of ice or cold application should be used (depending on the temperature and intensity of the therapy).

Heat promotes increased blood flow and circulation.  It is often used in the days and weeks following an injury or in cases of chronic problems such as arthritis or muscle tension.  Heat can promote muscle relaxation and increase oxygen delivery or immune cells to boost recovery. Warm compresses or heating pads should not be used for more than 20 minutes at a time with appropriate monitoring.  Following these simple guidelines can help minimize tissue damage and inflammation following an injury or intense workout, while promoting tissue recovery in the days and weeks that follow.

Written by Dr. Judd Cummings 

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